Emergency Radiology

1. Emergency Radiology

2. Emergency Department clinical Radiology Labaratory

3. Patient presenting either: Trauma Acute diseases

4. At Trauma setting Clinical Skull base fracture TensionPneumothorax Flail chest Hematuria

5. Penetrating Trauma Bullets Stab wound Eviseration Impalement

6. Acute Setting Tenderness at Mecburnys point Clinical Murphys sign Unequal pulse in aortic dissection Crepitations in congestive heart failure

7. Labarotry In Trauma setting 1-CBC ,HB& blood typing. 2- ABG. 3-urine analysis (microhematuria) 4-Renal Functions (creatinine). 4-Liver enzymes(elevated in liver injury). 6-Pancreatic Amylase (elevated in pancreatic injury).

8. At The Acute Setting 1-CBC(total leucocytic count). 2-ABG. 3-urine analysis(cyrstals,microhematuria&pus cells). 4-Liver Enzymes. 5-Pancreatic Amylase. 6-Blood Electrolytes. 7-ECG & Cardiac enzymes in chest pain.

9. What About Radiology Dudes!??

10. Radiography

11. In Trauma Setting(protocol of x-ray in Trauma Patient)(Trauma Series) Cervical spine ( (AP,Lat,Openmouth) CXR(AP) Pelvic Xray(AP)

12. X-rays of the Trauma Patient • For the trauma patient, “x-ray everything that hurts.”The only caution is that unimportant x-rays not take precedence over treatment of life-threatening problems. For example, don’t delay operating on an epidural hematoma to take hand x-rays. If x-rays must be deferred, the reason for the delay should be written on the chart, along with a clear list of the x-rays desired. The films can be obtained later. Splint any extremity with a possible fracture if x-ray will be delayed. • Almost every patient with severe trauma should have a cross-table C-spine x-ray, chest x-ray, and pelvis x-ray. The rationale: Neck pain may be missed in a massively-injured patient, and the cost of missing a cervical fracture is great. The chest may have significant internal injury without external tenderness. Pelvic fractures are often present in patients with trunk trauma, and are often missed. Order these important x-rays before the patient leaves the emergency department for other care.

13. Extremity Contrast Enhanced

14. At The Acute Setting CXR Abdominal Xray (Erect,supine&lateral decubitus) Extremity

15. Ultrasound

16. Types of Probes

17. At The Trauma setting FAST Examination At The Acute setting discussed later

18. CT

19. At the trauma setting Brain chest Abd&pelvis bones Orbit

20. At The Acute Setting CT brain in Hge or infarction or tumors CT orbit in ophalmitis CT CHEST (e.g. dissection) Abd&pelvis

21. 1-TRAUMA Blunt Trauma Penetrating Trauma

22. BLUNT TRAUMA (Causes) MVA Fall from height Fight

23. Mechanism of Injury Compression Crushing Shearing (Acceleration/Deceleration)

24. Penetrating Injuries Stab Gun shot injury

25. Mechanism of injury Low-velocity projectiles • A knife or projectile, for example, produces tissue damage by stretching and crushing; injury is usually confined to tissues in the path of penetration • The severity of the internal injury depends on the organ penetrated and on how vital the organ is. High Velocity Projectiles • GSI leads to injury along its path + by shock waves to the adjacent structures. (so it’s more dangerous) • The degree of injury also depends on the biomechanics of the penetrating projectile . • velocity, size of impact face, and deformability, and the density of the body tissues penetrated

26. you can continue emergency radiology for each specialty;